Proper Techniques for Moving Patients with Spinal Cord Injuries

Spinal cord injuries require immediate and careful handling to prevent further damage, especially in cases involving the cervical spine. Improper movement or transportation of an injured person can lead to permanent paralysis or even death. Therefore, understanding and applying correct immobilization and transfer techniques is critical for first responders, medical personnel, and anyone involved in emergency care.

Initial Immobilization Before Transport

Before any movement occurs, it's essential to stabilize the patient's spine—particularly the neck—to maintain spinal alignment. The first step in managing a suspected cervical spine injury is proper head and neck immobilization.

Use of Head Immobilization Devices

Specialized head stabilization tools, such as rigid head blocks or vacuum immobilizers, should be used in combination with a cervical collar (commonly referred to as a neck brace). These devices help restrict any lateral or rotational movement of the head, minimizing the risk of additional spinal cord trauma.

Manual In-Line Stabilization

In emergency settings where equipment is not immediately available, trained personnel should perform manual in-line stabilization. This involves gently holding the patient's head with both hands to maintain neutral alignment of the cervical spine. Once stabilized, a properly fitted cervical collar can be applied without compromising spinal positioning.

Correct Patient Transfer Techniques

Once the head and neck are secured, the next phase is safely transferring the patient onto a rigid surface for transport. Every movement must be coordinated and controlled to avoid twisting or bending of the spine.

Use of a Rigid Backboard

A long, rigid backboard—typically made of wood or high-density plastic—is the standard tool for transporting individuals with spinal injuries. This prevents flexion, extension, or rotation of the spine during movement. Soft stretchers or flexible surfaces are strictly prohibited, as they cannot provide adequate support.

Coordinated Lifting by Multiple Responders

At least three rescuers should participate in the lifting process. All team members must act simultaneously, using a synchronized "log roll" or horizontal lift technique. Each responder supports a different part of the body—head, torso, pelvis, and legs—ensuring that the entire body moves as one unit. Sudden jerks or uneven lifting can cause shearing forces on the spine, leading to irreversible damage.

Securing the Patient for Transport

After placing the patient on the backboard, additional measures must be taken to prevent movement during transit. Sandbags or foam pads are placed on either side of the head and torso to limit shifting. A wide strap or securing belt is then used across the chest, hips, and legs to firmly fasten the individual to the board. The head should remain immobilized throughout the journey.

Special Considerations for Cervical Spine Injuries

Patients with confirmed or suspected cervical spine trauma require continuous monitoring and support during transport. Even slight misalignment can exacerbate neurological deficits.

A dedicated team member must maintain manual head stabilization throughout the entire transfer process, from initial immobilization until the patient is securely fastened on the backboard and during ambulance or helicopter transport. Communication among team members is crucial to ensure smooth transitions between stages of movement.

By following these evidence-based protocols, emergency responders significantly reduce the risk of secondary injury and improve long-term outcomes for spinal cord trauma patients. Proper training, teamwork, and adherence to safety guidelines are key elements in delivering effective pre-hospital care.